{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T12:58:57Z","timestamp":1762865937352},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2012,11,15]],"date-time":"2012-11-15T00:00:00Z","timestamp":1352937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aim\u2002<\/jats:bold> The effect of vaginal delivery and ageing on the anatomy of the anal canal was assessed using three\u2010dimensional anorectal ultrasound to determine the interobserver reliability.<\/jats:p><jats:p><jats:bold>Method\u2002<\/jats:bold> One\u2010hundred and eighteen asymptomatic women without sphincter damage were grouped according to parity and mode of delivery. They were then stratified by age (\u226450\u2003years <jats:italic>vs<\/jats:italic> &gt;50\u2003years). Group I consisted of 35 nulliparous women, of mean ages 36\u2003years (<jats:italic>n\u2003<\/jats:italic>=\u200320) and 62\u2003years (<jats:italic>n\u2003<\/jats:italic>=\u200315), Group II consisted of multiparous women, having one or more vaginal deliveries (<jats:italic>n<\/jats:italic>\u2003=\u200343), of mean ages 43\u2003years (<jats:italic>n<\/jats:italic>\u2003=\u200320) and 60\u2003years (<jats:italic>n<\/jats:italic>\u2003=\u200323) and Group III consisted of women who had a Caesarean section (<jats:italic>n<\/jats:italic>\u2003=\u200340) of mean ages 41\u2003years (<jats:italic>n<\/jats:italic>\u2003=\u200320) and 56\u2003years (<jats:italic>n<\/jats:italic>\u2003=\u200320). The groups were compared with regard to the length and the thickness of the external anal sphincter, the internal anal sphincter, the posterior external sphincter and the puborectalis in all quadrants and the anterior gap. Interobserver variability was assessed.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> In women having vaginal delivery the length of the anterior external sphincter was shorter (<jats:italic>P<\/jats:italic>\u2003=\u20030.0004) and the gap was longer (<jats:italic>P<\/jats:italic>\u2003=\u20030.0306). The external sphincter tended to be thinner in individuals having vaginal delivery (<jats:italic>P<\/jats:italic>\u2003=\u20030.0677) and in those subjects over 50\u2003years of age having had a vaginal delivery (<jats:italic>P<\/jats:italic>\u2003=\u20030.0164). In nulliparous women, the internal sphincter was thicker in subjects over 50\u2003years of age (<jats:italic>P<\/jats:italic>\u2003=\u20030.0229). The intraclass correlation coefficient was 0.755\u20130.916 for sphincter muscle and gap length and 0.446\u20130.769 for muscle thickness.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> Vaginal delivery was associated with a shorter anterior external sphincter, a longer gap and a thinner anterior external sphincter in asymptomatic women. Age was correlated with sphincter thickness, and nulliparous women &gt;50\u2003years of age had a thicker internal sphincter. Three\u2010dimensional ultrasound was found to be a reliable method for measuring anal structures.<\/jats:p>","DOI":"10.1111\/j.1463-1318.2012.03033.x","type":"journal-article","created":{"date-parts":[[2012,3,19]],"date-time":"2012-03-19T10:52:22Z","timestamp":1332154342000},"page":"1521-1527","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effect of vaginal delivery and ageing on the anatomy of the female anal canal assessed by three\u2010dimensional anorectal ultrasound"],"prefix":"10.1111","volume":"14","author":[{"given":"S. M.","family":"Murad\u2010Regadas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. S. P.","family":"Regadas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. 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